WCPanelIQ
PanelQMEMed-legalGranted

Herrera, Rosalina

ROSALINA HERRERA, Applicant vs. TESLA MOTORS, INC; SENTRY INSURANCE COMPANY, formerly known as SENTRY INSURANCE MUTUAL, Defendants

ADJ number
ADJ9840500
Decision date
Date unavailable
District office
Anaheim
WCJ
Tammy Homen
Claim administrator
Sentry Insurance Company, formerly known as Sentry Insurance Mutual
Commissioners
—

Injury / body parts: psyche, bilateral carpal tunnel, hypertension, gastrointestinal (GI), digestive, esophagus, cognitive, stomach, arms, spine, legs, headaches, migraines

LC §3202LC §5506LC §5701LC §5708LC §5709LC §5813LC §5906CCR §31.7CCR §10517CCR §10945CCR §10964

Summary

Applicant Rosalina Herrera sought reconsideration of a WCJ's Findings and Award that denied her an additional QME panel in psychiatry/psychology. The WCJ had found applicant was not entitled to the panel and rejected challenges to the QME reports of Dr. Levy (internal medicine) and Dr. Mehta (orthopedics). The Appeals Board granted reconsideration on the psyche-panel issue, finding that although applicant never pleaded a psyche injury, orthopedic QME Dr. Mehta's 2019 report stated a psyche evaluation was necessary to address her anxiety and depression. Invoking liberal pleading principles and the Board's authority to develop the record, the Board conformed the pleadings to proof, found applicant claimed a psyche injury, ordered an additional QME panel in psychiatry/psychology, and deferred the issue of whether the psyche injury caused further permanent disability. The Board otherwise adopted the WCJ's Report and made no other substantive changes, leaving the 49% permanent disability award intact.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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